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Nitrous oxide analgesia during intra-articular injection for juvenile idiopathic arthritis

A G Cleary1, A V Ramanan, E Baildam

  • 1Department of Paediatric Rheumatology, Royal Liverpool Children's Hospital, UK. gavin.cleary@talk21.com

Archives of Disease in Childhood
|May 23, 2002
PubMed

Insights

Nitrous oxide-oxygen provides safe and effective pain relief for children with juvenile idiopathic arthritis (JIA) during corticosteroid injections. Patient-reported pain was higher than nurse or parent assessments, indicating potential underestimation by caregivers.

Area of Science:

  • Pediatric Rheumatology
  • Pain Management
  • Anesthesiology

Background:

  • Juvenile idiopathic arthritis (JIA) often requires intra-articular corticosteroid injections for treatment.
  • Effective pain management during these procedures is crucial for pediatric patients.
  • Nitrous oxide-oxygen inhalation is a potential analgesic option for children.

Purpose of the Study:

  • To assess the efficacy and safety of nitrous oxide-oxygen for analgesia in children with JIA undergoing intra-articular corticosteroid injections.
  • To compare pain scores reported by patients, nurses, and parents.

Main Methods:

  • A study involving 55 consecutive JIA patients receiving intra-articular corticosteroid injections.
  • Self-administered nitrous oxide-oxygen was used for analgesia.
  • Pain was measured immediately post-procedure using a 0-10 cm visual analogue scale (VAS) by patients, nurses, and parents.

Main Results:

  • 70 joints were injected in 55 patients (median age 13.54 years).
  • The median pain score across patient, nurse, and parent was 1 (0-10 cm VAS).
  • Patient pain scores were significantly higher than those reported by nurses and parents, suggesting potential underestimation by non-patients.

Conclusions:

  • Nitrous oxide-oxygen is a safe and effective analgesic for intra-articular injections in children with JIA.
  • Healthcare providers and parents may underestimate procedural pain experienced by children.
  • This highlights the importance of patient-reported outcomes in pain assessment.
Abstract

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